Abstract:
Abstract
Background: Vitamin A deficiency remains a global public health problem. Daily supplementation with a lipid-based
nutrient supplement (LNS) has potential for increasing milk vitamin A concentrations.
Objective: The objective of this study was to determine whether daily supplementation with approximately the
recommended daily intake of vitamin A in an LNS or a multiple-micronutrient supplement (MMN) during pregnancy and the
first 6 mo postpartum has an effect on breast milk retinol concentration at 6 mo postpartum.
Methods: Women #20 wk pregnant (n = 1320) were randomly assigned to receive either the MMN providing 18
micronutrients, including 800 mg retinol equivalents of vitamin A, or the LNS with the same nutrients as the MMN group,
plus 4 minerals and macronutrients, until 6 mo postpartum; a control group received iron and folic acid during pregnancy
and a placebo (calcium tablet) during the first 6 mo postpartum. Breast milk samples collected at 6 mo postpartum were
analyzed for retinol and fat concentrations by HPLC and creamatocrit, respectively, in a subsample of 756 women.
Results: The breast milk retinol concentration was (mean 6 SD) 56.3 6 2.1 nmol/g fat, with no significant differences
between groups [iron and folic acid (n = 243): 59.1 62.8;MMN(n = 260): 55.4 6 2.5; LNS (n = 253): 54.76 2.5 nmol/g fat;
P = 0.45], regardless of whether the woman had or had not received a high-dose vitamin A supplement (200,000 IU) soon
after childbirth. Around 17% of participants had low milk retinol (#28 nmol/g fat). We estimated that 41% of infants were
potentially receiving vitamin A at amounts above the Tolerable Upper Intake Level (600 mg retinol activity equivalents/d),
with no group differences in percentages with low or high milk retinol concentration.
Conclusion: Daily consumption of approximately the recommended intake of vitamin A did not increase breast milk retinol
concentrations in this sample of Ghanaian women.
